Dual Heterotropic Tissue Associated with a Type IV A Choledochal Cyst: A Rare Case Report

Abstract

A choledochal cyst (CC) is one of the rare congenital diseases of the biliary tract and is more common in females. The association of ectopic pancreatic and splenic tissue with CC is an extremely rare condition. An 11-year-old girl child presented with a vague abdominal lump and intermittent dull abdominal pain for 5 months with early satiety and weight loss in the current case scenario. Her laboratory findings were normal. A type IV CC was discovered on ultrasonography, and the distal common bile duct displayed significant cystic dilatation on magnetic resonant cholangiopancreatography. After the CC was surgically removed, it was sent for histopathological examination. Sections revealed dual heterotropic elements, which included pancreatic and splenic tissues in a CC. It was very uncommon for both to exist independently in the CC and in this instance, both were observed together. This will be the first documented case, in which the CC contained dual ectopic tissue from the spleen and pancreas. Ectopic splenic tissue in the CC has never been documented in the literature. It is crucial to be aware of this entity when splenic or pancreatic tissue experiences changes due to inflammation, even though its clinical significance is uncertain. In the ectopic rests, bleeding, blockage, and malignant transformation are the possible outcomes.

Keywords

• choledochal cyst
• ectopic tissue
• heterotropic pancreas
• heterotropic spleen
• pediatric